Ian is a palliative care specialist at Fort portal Referral hospital, with more than 8 years of experience in clinical patient care.
The Covid-19 pandemic is a serious burden on health care systems globally. To avoid overwhelming hospitals and to continue care for patients with other diseases, certain categories of Covid-19 patients are put in home-based care.
This means that the families of such patients have to assist the healthcare team in managing their loved one. Unfortunately, this trend is likely to continue into the foreseeable future because Covid-19 appears to be going nowhere any time soon.
Caring for a Covid-19 patient at home must be frightening for caregivers for a number of reasons. A typical health worker in the hospital covid treatment unit dresses up in a spacesuit-like protective gear which is out of reach for caregivers. In addition, caregivers may have no training in patient care, yet the caregiving role exposes them to the risk of infection. The stigma around Covid-19 also makes the fear and anxiety worse.
Therefore, caregivers of patients in home-based care need a lot of support to help them to cope with their role while minimizing the risk of catching the infection. This article outlines what families can do to achieve a relatively safe environment for the patient and everyone at home.
According to Dr. Kimuli Ivan, a physician and lecturer at Makerere university college of health sciences, some of the things your doctors will consider when assessing the possibility of home-based care include; severity of the patient’s illness, presence of a room for isolating the patient, availability of an adult caregiver, among others. Patients with mild illness are the ones who qualify for home-based care.
How should caregivers go about caring for a Covid-19 patient at home?
Have a plan for preventing infection within the home.
If a Covid-19 patient is to be managed at home, there has to be a plan to prevent the spread of the disease. This plan should be made in consultation with the health care professionals responsible for the patient’s treatment.
In my view, all members of the home should participate in making this plan so that they can understand it. If possible, divide up the roles so that everyone is responsible for something. This will ensure that everyone owns the plan, which will improve compliance. The plan can include;
Identifying a leader for the care team at home
It is extremely important to identify a leader who will help motivate others and keep a positive outlook on the situation. This person should also be responsible for liaising with health workers at a treating facility. The leader of the team should ensure that everyone understands how vital their role is in the successful management of the patient.
Identifying a room for isolating the patient
Some members of the home may have to be displaced or have to share a room to create space for the patient. If this involves children, you need to make them understand why this has to happen.
Determining who will participate directly in the care of the patient
Dr. Kimuli adds that the patient in home-based care is capable of self-care because they are only mildly or moderately ill. They’re able to take their medication without much assistance. Therefore, identify one or two people to be the direct caregivers. The roles of the direct caregiver may include; serving food, monitoring the patient, dealing with laundry, and assisting with cleaning their room. Other family members can support with less direct roles such as preparing meals and running errands for the patient. The direct caregiver should be an adult preferably free from illnesses that would make them vulnerable to Covid-19 such as diabetes, cancer, or pregnancy.
Preparing facilities for hand hygiene and personal protection
The person directly caring for that patient should have gloves and a face mask. A face shield and plastic apron may be added if the patient is coughing. Handwashing facilities should be present and accessible for everyone. All members of the family should have a facemask at all times. Wash all cloth face masks and iron them regularly.
Cleaning all surfaces regularly
Clean all surfaces such as tables chairs, and door handles regularly with clean water and soap. The world health organization (WHO) provides some guidelines on cleaning and disinfecting surfaces in non-healthcare settings. You can find the guidelines here.
If possible, the patient should clean their room but can be assisted to take out the trash. It is important that you avoid sharing personal items with the patient. If anyone develops symptoms, report to the Covid case management team right away.
Alcohol-based hand sanitizer should be available to minimize the spread of infection.
Have regular telephone contact with a health facility.
It is extremely important to establish regular contact with the covid treatment team. This is necessary for seeking assistance or clarification with anything you may not understand about the patient’s care plan. The health workers will also want to check on the patient regularly to see how he or she is fairing. This regular check-up and contact help the patient to not feel abandoned by the health care system. It is also an opportunity to report if the patient is deteriorating.
Have patient monitoring equipment that is easy to use.
If possible, obtain a pulse oximeter and a thermometer. These will help in monitoring the patient’s progress. Your doctors may provide charts in which to record the readings of the thermometer and pulse oximeter. Record these carefully and honestly. These readings will help the Covid-19 treatment team when they review the patient to determine the progress of the illness.
Last but certainly not least, Dr. Kimuli advises that caregivers should avoid substance abuse like the use of alcohol as a strategy of coping with stress. The use of such substances, can alter judgment and increase the risk of infection. It can also lead to other health problems. Remember to work together as a team. When everyone understands the magnitude of the task at hand, it is easier to minimize the risk of transmission.
It is important to note, that home-based care must be recommended only by a team of qualified health professionals after they have assessed the practicalities of caring for the patient within their home. Therefore, avoid the temptation of deciding to keep your patient at home without the recommendation of health care professionals.
This content reflects the personal opinions of the author. It is accurate and true to the best of the author’s knowledge and should not be substituted for impartial fact or advice in legal, political, or personal matters.
© 2021 Ian Batanda